Continuous Dialysis Therapies: Core Curriculum 2016
This edition of the core curriculum nicely summarizes continuous dialysis therapies.
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Onco-Nephrology: Core Curriculum 2015.
Hemodialysis: core curriculum 2014.
CKD–Mineral and Bone Disorder: Core Curriculum 2011 (Source: Nephrology Now)
Source: Nephrology Now - November 11, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: AJKD Core Curriculum Hemodialysis Source Type: research
The relatively poor correlation between random and 24-hour urine protein excretion in patients with biopsy-proven glomerular diseases
This study measured the urine protein and creatinine centrally in random and 24-hour urine collections at biopsy and longitudinally every 6 months in individuals participating in the Nephrotic Syndrome Study Network (NEPTUNE) cohort with glomerular disease. The results show that in patients with glomerular disease and proteinuria, the urine protein creatinine ratio correlates only moderately with 24-hour urine protein excretion. The results were used to develop estimating equation to derive 24-hour urine protein excretion from random urine protein creatinine ratio values with improved precision...
Source: Nephrology Now - November 11, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology General Nephrology Glomerulonephritis Source Type: research
A new model to predict acute kidney injury requiring renal replacement therapy after cardiac surgery
The authors of this study developed and validated a risk prediction model for acute kidney injury requiring renal replacement therapy within 14 days after cardiac surgery. They identified 8 independent predictors of acute kidney injury requiring renal replacement therapy in the derivation model(adjusted odds ratio, 95% confidence interval [CI]): congestive heart failure (3.03, 2.00-4.58), Canadian Cardiovascular Society angina class III or higher (1.66, 1.15-2.40), diabetes mellitus (1.61, 1.12-2.31), baseline estimated glomerular filtration rate (0.96, 0.95-0.97), increasing hemoglobin concentration (0.85, 0.77-...
Source: Nephrology Now - November 11, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Acute Kidney Injury Clinical Nephrology Hemodialysis Source Type: research
Efficacy of Folic Acid Therapy on the Progression of Chronic Kidney Disease The Renal Substudy of the China Stroke Primary Prevention Trial
In this substudy of eligible China Stroke Primary Prevention Trial (CSPPT), 15 104 participants with an estimated glomerular filtration rate (eGFR) 30 mL/min/1.73 m2 or greater, were randomized to receive a single tablet daily containing 10 mg enalapril and 0.8 mg folic acid (n = 7545) or 10 mg enalapril alone (n = 7559). Overall, 15 104 Chinese adults with a mean (range) age of 60 (45-75) years were recruited; median follow-up was 4.4 years. There were 164 and 132 primary events in the enalapril group and the enalapril-folic acid group, respectively. Compared with the enalapril group, the enalap...
Source: Nephrology Now - November 11, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Clinical Nephrology Source Type: research
Bariatric surgery is associated with improvement in kidney outcomes
In this matched cohort study, 985 patients who underwent bariatric surgery were compared 985 patients that did not. The mean 1-year weight loss was 40.4 kg in the surgery group compared with 1.4 kg in the matched cohort. In adjusted analyses, bariatric surgery patients had a 58% lower risk for an eGFR decline of ≥30% (hazard ratio 0.42, 95% confidence interval 0.32-0.55) and 57% lower risk of doubling of serum creatinine/ESRD (hazard ratio 0.43, 95% confidence interval: 0.26-0.71) compared with the matched cohort.
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High-Efficiency Postdilution Online Hemodiafiltration Reduces All-Cause Mortality in Hem...
Source: Nephrology Now - August 14, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease General Nephrology Source Type: research
Past Decline Versus Current eGFR and Subsequent ESRD Risk
This CKD Prognosis Consortium study examined 22 cohorts to determine the association of past slopes and current eGFR level with subsequent ESRD. 5163 ESRD events were recorded in the 1,080,223 participants during a mean follow-up of 2.0 years. The results showed that current eGFR [30 versus 50 ml/min per 1.73 m(2) (a difference of 20 ml/min per 1.73 m(2)) associated with an adjusted hazard ratio of 19.9 (95% confidence interval, 13.6 to 29.1)] was more strongly associated with future ESRD risk than the magnitude of past eGFR decline [a slope of -6 versus 0 ml/min per 1.73 m(2) per year over the previous...
Source: Nephrology Now - August 14, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Clinical Nephrology General Nephrology Source Type: research
Past Decline Versus Current eGFR and Subsequent Mortality Risk
This is an individual-level meta-analysis of the risk of mortality associated with antecedent eGFR slope among 1.2 million subjects within the CKD Prognosis Consortium. Over a 3-year antecedent period, compared with a slope of 0 ml/min per 1.73 m(2) per year, a slope of -6 ml/min per 1.73 m(2) per year was associated with adjusted hazard ratios for all-cause mortality of 1.25 (95% confidence interval [95% CI], 1.09 to 1.44) among CKD cohorts and 1.15 (95% CI, 1.01 to 1.31) among other cohorts during a follow-up of 3.2 years. Results were similar for cardiovascular and non cardiovascular causes of death and stronger f...
Source: Nephrology Now - August 14, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Clinical Nephrology Clinical Trial Results Source Type: research
Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75Years: A Randomized Clinical Trial
This is a multicenter, randomized clinical trial of patients aged 75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT) to determine the effects of intensive (<120 mm Hg) compared with standard (<140 mm Hg) SBP targets.
The primary cardiovascular disease outcome was a composite of nonfatal myocardial infarction, acute coronary syndrome not resulting in a myocardial infarction, nonfatal stroke, nonfatal acute decompensated heart failure, and death from cardiovascular causes. All-cause mortality was a secondary outcome. At a median follow-up of 3.14 years ...
Source: Nephrology Now - August 14, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Trial Results Hypertension Source Type: research
Renal Complications of Hematopoietic-Cell Transplantation
This is a nice review of the topic.
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Vasopressin Antagonists
Proximal renal tubular acidosis: a not so rare disorder of multiple etiologies
An approach to cystic kidney diseases: the clinician’s view (Source: Nephrology Now)
Source: Nephrology Now - August 14, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Review Source Type: research
Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit
This multicenter randomized trial assigned 620 ICU patients with severe stages 1-3 AKI with either an early dialysis start (at randomization) or late dialysis start (a classic indication to initiate). The primary outcome was survival at day 60. There was no survival difference between the groups at day 60; 150 deaths occurred among 311 patients in the early-strategy group (48.5%; 95% confidence interval [CI], 42.6 to 53.8), and 153 deaths occurred among 308 patients in the delayed-strategy group (49.7%, 95% CI, 43.8 to 55.0; P=0.79). 49% of patients in the delayed-strategy group did not receive renal-replace...
Source: Nephrology Now - August 14, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Acute Kidney Injury Clinical Nephrology Clinical Trial Results Source Type: research
Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes
This randomized control trial of over 4000 high risk patients with Type 2 diabetes and eGFR > 30 ml/min, empagliflozin (a sodium-glucose cotransporter 2 inhibitor) when compared with placebo was associated with slower progression of kidney disease (12.7% vs 18.8% for worsening nephropathy and 1.5% vs 2.6% for doubling of serum creatinine) when added to the standard of care. Renal replacement therapy was initiated in 0.3% of the treatment group vs 0.6% of the placebo group (55% lower relative risk).
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Intensive Diabetes Therapy and Glomerular Filtration Rate in Type 1 Diabetes
Tolvaptan in Patients ...
Source: Nephrology Now - August 14, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Chronic Kidney Disease Clinical Nephrology Clinical Trial Results Diabetes General Nephrology Source Type: research
Lupus nephritis management guidelines compared
This review summarizes the 6 difference guidelines for treatment lupus nephritis – the commonalities, differences as well as highlights the recent literature.
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Mycophenolate Mofetil or Intravenous Cyclophosphamide for Lupus Nephritis With Poor Kidney Function: A Subgroup Analysis of the Aspreva Lupus Management Study
The Pathogenesis of Lupus Nephritis
Updates on the Treatment of Lupus Nephritis (Source: Nephrology Now)
Source: Nephrology Now - August 14, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Clinical Practice Guidelines Glomerulonephritis Lupus Source Type: research
Management of the Hemodialysis Unit: Core Curriculum 2016
This interesting core curriculum article summarizes all the facets involving in running and maintaining a hemodialysis unit. It is valuable information for both trainees and practicing nephrologists.
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Autosomal Dominant Polycystic Kidney Disease: Core Curriculum 2016
Glomerular Diseases Dependent on Complement Activation, Including Atypical Hemolytic Uremic Syndrome, Membranoproliferative Glomerulonephritis, and C3 Glomerulopathy: Core Curriculum 2015
Home Hemodialysis, Daily Hemodialysis, and Nocturnal Hemodialysis: Core Curriculum 2009 (Source: Nephrology Now)
Source: Nephrology Now - August 14, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: AJKD Core Curriculum Source Type: research
Pregnancy across the spectrum of chronic kidney disease
This paper highlights some of the available data as well as management strategies for nephrologists managing pregnant patients with chronic kidney disease.
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Stage IV Chronic Kidney Disease
Update in Nephrology
Pregnancy Outcomes in Women with Chronic Kidney Disease: A Systematic Review (Source: Nephrology Now)
Source: Nephrology Now - May 29, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Pregnancy and Hypertension/Renal Disease Source Type: research
Treatment with Glucocorticoids or Calcineurin Inhibitors in Primary FSGS
In the 458 patients were studied, the use of calcineurin inhibitors and/or glucocorticoids as part of the early immunosuppressive regimen in primary FSGS was associated with improved renal outcome. However, the superiority of calcineurin inhibitors over glucocorticoids alone remains unproven.
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Fixed- or Controlled-Dose Mycophenolate Mofetil with Standard- or Reduced-dose Calcineurin Inhibitors: The Opticept Trial
A Phase III Study of Belatacept-based Immunosuppression Regimens versus Cyclosporine in Renal Transplant Recipients (BENEFIT Study)
The ORION Study: Comparison of Two Sirolimus-Based Regimens versus Tac...
Source: Nephrology Now - May 29, 2016 Category: Urology & Nephrology Authors: Nephrology Now editors Tags: Clinical Nephrology Glomerulonephritis Source Type: research
